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Biomedical subjects

M Gignoux

Publications and source records attributed to M Gignoux.

At least 91 records · Page 5Linked to original sources
PubMed1989

[Esophageal cancer at the department of Calvados. Geographic and social inequality factors].

The Calvados Registry of Digestive Tract Tumours registered 620 cases (582 males and 38 females) of oesophageal cancer during a six-year period (1978-1983). The age-standardized incidence rate (world standard) was 29.6 per 100,000 for males and 1.2 for females. The sex-ratio was 25. The rural area was a high-risk region compared to the urban, the age standardized rate was 38.8 per 100,000 vs 26.1 for males. The cantons from Caen showed a low risk compared to the departement as a whole (SIR = 69), while certain clustered cantons showed a high risk (SIR greater than 200). An important proportion of poor housing characterized those cantons. Agriculture, industry and building were high-risk sectors, the SIR were respectively 191, 135 and 170. The risk of oesophageal cancer is twelve times higher in manual workers, agricultural or other, than in those in management or craftsmen.

Esophageal Neoplasms↗
PubMed1989

[Adjuvant radiochemotherapy in operable cancers of the thoracic esophagus. Preliminary results of a multicenter study. A study of 119 cases].

119 operable patients with an oesophageal squamous cell carcinoma were treated preoperatively by a combination of radiotherapy (37 Gy in two courses) and chemotherapy by cisplatin (delivered before each course of radiation). The response was evaluated on the resected specimen. 111 patients underwent operation and 101 tumours were resected. The toxicity was acceptable by reducing the Cisplatin dosage from 100 mg/m2 to 80 mg/m2 for the last 67 patients. A complete response was observed in 24 patients and a partial response in 46. The preliminary results show a 57% eighteen-month survival in the group of resected patients. A controlled study is needed to compare this combined regimen versus surgery alone in curatively resectable patients.

Adult↗
PubMed1989

Adjuvant radiotherapy and chemotherapy in resectable gastric cancer. A randomized trial of the gastro-intestinal tract cancer cooperative group of the EORTC.

One hundred and fifteen patients with curative and palliative surgery for gastric cancer were randomized to receive radiotherapy alone (1) or in combination with short-term (ST) 5-FU (2), long-term (LT) 5-FU (3), ST and LT 5-FU (4). The ST 5-FU was given at a daily dose of 575 mg/m2, every 4-6 h during the first 4 days of treatment before starting irradiation. The LT 5-FU was given at a dosage of 750 mg/m2 every 2 weeks for 18 months or until progression. The median survival times for treatment 1 to 4 was respectively 12, 10, 15 and 18 months. There was a statistically significant overall difference between the four treatments (P = 0.041). However, when the comparisons were adjusted for the most significant prognostic factors, the difference in survival disappeared. Moreover, no difference was found between treatments in terms of time progression. Nevertheless, among 22 patients with residual tumour, the three who were still alive without disease progression (with survivals of 19+, 49+ and 90+ months at the time of this analysis) had been treated with radiotherapy combined with ST and LT 5-FU.

Adenocarcinoma↗
PubMed1989

[Proximal and distal cancers of the colon: 2 epidemiologically different cancers].

During a seven year period ending in 1984, the Calvados Registry of Digestive Tract Tumors (France) recorded 1446 cases of colorectal cancer. The sex-ratio, age, and histologic type were studied with respect to location. From cecum to rectum, the sex-ratio varied from 1 to 1.9. Average age at diagnosis varied between 67.5 and 72.6 years for women but was invariable for males. The proportion of mucinous carcinoma varied between 13 p. 100 in the cecum and 5 p. 100 in the sigmoid and rectum. The study of incidence with respect to age and location showed that there were less elderly women with left colonic and rectal carcinoma. Epidemiologically, there seems to be two different types of colonic carcinoma: proximal and distal colonic carcinoma (including the rectum), the separation being determined by the splenic flexure.

Adenocarcinoma↗
PubMed1989

[Esophagectomy without thoracotomy using a stripping method: technic, results, indications in benign and malignant diseases of the esophagus].

A technique of esophagectomy without thoracotomy using a stripper with limited dissection of the mediastinum has been applied to 48 patients: neoplasia in 41 (squamous-cell carcinoma of the esophagus: 34, carcinoma of the gastric cardia: 5, pharyngeal carcinoma: 2) and non-malignant pathology in 7 (2 caustic necroses, 2 ruptured esophagus, 2 anastomotic leakages after gastro-esophageal resection, 1 caustic stenosis). There were 3 post-operative deaths. The best indications of this procedure are extended tumors of the lower esophagus in poor-risk patients, and perhaps superficial carcinomas of the esophagus whatever the site. The usefulness of this technique in such situations as perforations and mediastinitis is emphasized.

Adult↗
PubMed1988

Preoperative radiotherapy as adjuvant treatment in rectal cancer. Final results of a randomized study of the European Organization for Research and Treatment of Cancer (EORTC).

A randomized clinical trial was conducted by the European Organization for Research and Treatment for Cancer (EORTC) Gastrointestinal Cancer Cooperative Group to study the effectiveness of irradiation therapy administered in a dosage of 34.5 Gy, divided into 15 daily doses of 2.3 Gy each before radical surgery for rectal cancer (T2, T3, T4, NX, MO). Four hundred sixty-six patients were entered in the clinical trial between June 1976 and September 1981. Tolerance and side effects of preoperative irradiation were acceptable. The overall 5-year survival rates were similar in both groups. When considering only the 341 patients treated by surgery with a curative aim, the 5-year survival rates were 59.1% and 69.1% in the control group and in the combined modality group, respectively (p = 0.08). The local recurrence rates at 5 years were 30% and 15% in the control group and the adjuvant radiotherapy group, respectively (p = 0.003). Although this study did not show preoperative radiotherapy to have a statistically significant benefit on overall survival, it does have a clear effect on local control of rectal cancer. Therefore, before performing radical surgery, this adjuvant therapy should be administered to patients who have locally extended rectal cancer.

Adenocarcinoma↗
PubMed1988

[Descriptive epidemiology of cancer of the esophagus in the Department of Calvados: 520 cases (1978-1982)].

Over a five year period (1978-1982), 520 new cases (males = 492, females = 28) of esophageal carcinoma (OC) have been registered in the department of Calvados in Normandy (589,000 inhabitants). Data were collected from Hospital records, pathological institutes and physicians. Mean age was 62.1 years in males, 70.1 years in females (p less than 10(3]. A higher incidence was observed among farmers and workers in rural areas. A previous or synchronous cancer (mostly oro-pharyngeal) was associated in 86 patients (16.5 p. 100). Fourty-nine p. 100 of OC were located in the middle third of the esophagus. Histologic type was squamous cell in 91 p. 100, adenocarcinoma in 3 p. 100, and undifferentiated carcinoma in 6 p. 100. Esophageal resection was performed in 63, radiation therapy in 294, palliative surgical procedure in 91, and symptomatic treatment in the others. The overall 1-year survival rate was 31 p. 100 and the 5-year survival rate was 3 p. 100. Excluding patients with associated cancer, the survival rates were 40.5 p. 100 and 7.6 p. 100, respectively. In France, the department of Calvados has the highest incidence of OC. The standardised incidence rate in males (31.6/100,000) in Calvados is exceeded only in four countries in the world. Decreasing incidence (4.6 p. 100 each year) has been observed during the past six years (p less than 0.05).

Adult↗
PubMed1987

[Chemoembolization of hepatic metastases. Preliminary study].

Twenty-one patients with hepatic metastases were treated by chemoembolization over a 2-year period, the technique consisting of selective injection of a mixture of Spongel powder and Adriamycin plus 5-FU into the hepatic artery. Indications and results are discussed as a function of clinical, biologic and radiologic criteria.

Adult↗
PubMed1986

[Acute pancreatitis caused by lithiasis in a dilated ampulla of Vater].

Unusual features in a case of dilatation of ampulla of Vater were in the existence of biliary calculi in the diverticulum and lithiasis complicated by a revealing acute pancreatitis. Diagnosis was suggested from barium meal followed through images and confirmed by perioperative cholangiography. Surgical treatment of such cases is simple, allows recovery without sequelae and avoids risks of recurrence.

Acute Disease↗
PubMed1986

[Functional studies of the esophagus in gastroesophageal reflux: application to anti-reflux surgery].

A functional exploration of the esophagus, an acid reflux test, a manometry and an endoscopic examination were performed on 56 patients in succession, who had undergone a complete fundoplication for gastro-esophageal reflux. These tests were done pre-operatively as well as post-operatively at short term (1 year) and long term (4 years). The functional and endoscopic pre-operative work-up did not enable to isolate a group of patients likely to present a therapeutic failure. 54 patients were seen again at 1 year, with a good clinical result in 50 of them (92 per cent). At 4 years, 39 out of 48 patients (81 per cent) maintained that result. The acid reflux test was abnormal in all cases of clinical recurrence. Two asymptomatic patients had an abnormal test. One presented a clinical recurrence subsequently, the other had a severe esophagitis confirming the recurrence. On manometry, a significant and stable increase of the pressure of the lower esophageal sphincter was noticed after fundoplication (8.1 +/- 1.8 mmHg pre-operatively, 15.5 +/- 1.4 mmHg at 1 year, 14.5 +/- 1.5 mmHg at 4 years). In case of recurrence, the pressures were in an average lower although values within normal limits could not exclude a recurrence. A complete fundoplication is therefore a reliable long term procedure. The functional exploration of the esophagus post-operatively enables to select asymptomatic patients with a high recurrence risk and gives an objective evaluation of the operative results.

Adolescent↗
PubMed1985

[Evaluation of the activity and quality of care in a digestive surgery department].

Since 1980, details of all patients operated upon in a digestive surgery unit have been entered on record-cards with the view of obtaining information on the activity of the unit and improving post-operative care. Over a 3-year period, 2005 patients underwent surgery, 25% of them for cancerous lesions. Biliary tract operations (385 patients), fundoplication by the abdominal route for gastro-oesophageal reflux (58 patients) and curative resection of the colon for carcinoma (100 patients) were set apart for evaluation. For each of the above pathologies, morbidity, mortality and duration of stay in hospital in cases with uneventful or complicated post-operative course were analyzed. Annual audits of this kind result in accurate evaluation and periodical reappraisal of the therapeutic habits of the medico-surgical team.

Adolescent↗
PubMed1985

[Completed calibrated fundoplication].

Complete fundoplication at present is the most effective surgical treatment of gastro-oesophageal reflux. However, it has a number of side-effects, including post-operative dysphagia, inability to eructate and painful gastric distension. Fifty-five patients were operated upon using a technique which comprises wide gastric release and fabrication of a tension-free valve around a 50F probe introduced through the mouth. After 1 year, 94% of patients were free of reflux and 22% had mild dysphagia. After 3 years, the proportion of reflux-free patients still was 94%; 12% suffered from mild dysphagia and 6% had problems with eructation. Thus, calibration of the oesophagus with a 50F probe reduces the side-effects of complete fundoplication while remaining effective against gastro-oesophageal reflux.

Esophagus↗